456. Deputy Clare Daly asked the Minister for Health when the title of the National Clinical Programme for Obstetrics and Gynaecology will be changed to reflect the fact that the reality is that the majority of the workforce dealing with pregnancy and birth are midwives. (Question 11936/18 asked on 20 Mar 2018 - Maternity Services)

Minister for Health (Deputy Simon Harris): In relation to the query raised concerning the title of this Clinical Programme, I have asked the HSE to reply to you directly. 
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159. Deputy Clare Daly asked the Minister for Health the annual induction rates for first time mothers in each of the State’s 19 maternity hospitals and units for each of the years 2011 to 2016 and to date in 2017; and if he will make a statement on the matter. (Question 49545/17 asked on 22 Nov 2017 - Maternity Services)

Minister for Health (Deputy Simon Harris): I propose to take Questions Nos. 159 and 160 together.
Firstly, I would like to assure the Deputy that no national policy is in place which specifies a target number of births per bed in 24 hours. On the contrary, the National Maternity Strategy recognises pregnancy and birth as a normal physiological process. It recognises that all pregnant women require a certain level of support and that some will need more specialised care. As such, it proposes a...

160. Deputy Clare Daly asked the Minister for Health his views on the concerns expressed by the UN Committee on the Elimination of Discrimination Against Women in 2017 in regard to induction rates in Irish hospitals (details supplied); and if he will make a statement on the matter. (Question 49546/17 asked on 22 Nov 2017 - Maternity Services)

Minister for Health (Deputy Simon Harris): I propose to take Questions Nos. 159 and 160 together.
Firstly, I would like to assure the Deputy that no national policy is in place which specifies a target number of births per bed in 24 hours. On the contrary, the National Maternity Strategy recognises pregnancy and birth as a normal physiological process. It recognises that all pregnant women require a certain level of support and that some will need more specialised care. As such, it proposes a...

175. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 147 of 16 November 2017, when a reply will issue from the HSE to Parliamentary Question No. 650 of 26 July 2017 in view of the fact that a reply to Parliamentary Question No. 803 of 26 July 2017 was received on 8 August 2017. (Question 49650/17 asked on 22 Nov 2017 - Maternity Services)

Minister for Health (Deputy Simon Harris): I can advise the Deputy that I responded to her question, 850, regarding maternal deaths on 26 July 2017. At the same time I referred question 650 to the HSE for response, which was issued directly to the Deputy on 8 August 2017, a copy of which has been provided to the Deputy. 
As you will be aware, since December 2015, each of the 19 Maternity Units in the country are obliged to publish a Maternity Patient Safety Statements with 17 indicators on each...

294. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 699 of 26 July 2017, if part of the budget for maternity services was ring-fenced for 2016 or has been ring-fenced for 2017 for expansion of access to 20 week anomaly scans. (Question 40271/17 asked on 26 Sep 2017 - Maternity Services)

Minister for Health (Deputy Simon Harris): The National Maternity Strategy confirms that all development funding for maternity services will be ring-fenced and allocated through the HSE National Women & Infants Health Programme (NWIHP). The Programme, with its wide remit and dedicated expertise, will facilitate greater oversight and support for service providers and will ensure the appropriate allocation and targeting of new resources.
The National Maternity Strategy is also very clear that all...

650. Deputy Clare Daly asked the Minister for Health if there is now full compliance in regard to the collating of annual reports by all maternity units; and if the reports are made publicly available in all cases, in view of the fact that in 2014 documents released under FOI (details supplied) showed that eight maternity units around the country were not publishing annual reports. (Question 34909/17 asked on 26 Jul 2017 - Maternity Services)

Minister for Health (Deputy Simon Harris): I propose to take Questions Nos. 650 and 803 together.
The Deputy will be aware that the statistics reported to Maternal Death Enquiry Ireland (MDE Ireland) require anonymisation due to the small number of such incidents occurring across the country’s 19 maternity units. Thus, naming the hospitals and maternity units where such events occurred would not meet the Data Protection standards required for protection of otherwise identifiable patient informa...

699. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 176 of 6 July 2017, the funding made available in 2016 and to date in 2017, for the expansion of access to 20-week anomaly scans. (Question 35107/17 asked on 26 Jul 2017 - Maternity Services)

Minister for Health (Deputy Simon Harris): In relation to this particular query, I have asked the HSE to respond to you directly.
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803. Deputy Clare Daly asked the Minister for Health the hospitals and maternity units responsible for care in the 22 cases of direct and indirect maternal deaths (details supplied). (Question 35417/17 asked on 26 Jul 2017 - Maternity Services)

Minister for Health (Deputy Simon Harris): I propose to take Questions Nos. 650 and 803 together.
The Deputy will be aware that the statistics reported to Maternal Death Enquiry Ireland (MDE Ireland) require anonymisation due to the small number of such incidents occurring across the country’s 19 maternity units. Thus, naming the hospitals and maternity units where such events occurred would not meet the Data Protection standards required for protection of otherwise identifiable patient informa...

564. Deputy Clare Daly asked the Minister for Health if, in view of the fact that the maternity and infant care scheme last had a full review in 1994 when the reported costs of the general practitioner element of this combined care scheme was listed as nearly €17 million annually, when the scheme will be reviewed again in respect of its adherence to the current evidence base on antenatal care and value for money (Question 17966/17 asked on 11 Apr 2017 - Maternity Services Provision)

Minister for Health (Deputy Simon Harris): The Maternity and Infant Care Scheme provides an agreed programme of care, free of charge, to an expectant mother arising out of her pregnancy and to her new born baby for six weeks after birth. All expectant mothers who are ordinarily resident in Ireland are eligible to avail of services under the scheme. Women who choose to avail of these services are under the care of both a general practitioner of their choice and a hospital obstetrician. Care ca...

565. Deputy Clare Daly asked the Minister for Health if a review will be conducted of the CPD obligations of general practitioners that are providing combined care under the maternity and infant care scheme in respect of the current evidence base on antenatal care (Question 17967/17 asked on 11 Apr 2017 - Maternity Services Provision)

Minister for Health (Deputy Simon Harris): The Medical Council is designated as the regulatory body for all registered medical practitioners under the Medical Practitioners Act 2007. It has a statutory role in protecting the public by promoting the highest professional standards among medical practitioners practising in the Republic of Ireland.
The Medical Council has advised that all doctors are responsible for maintaining professional competence relevant to their scope of practice. Practiti...

569. Deputy Clare Daly asked the Minister for Health when all 19 maternity units will have a whole time or whole time equivalent perinatal mental health midwife specialist in place in view of the fact that the national maternity strategy set out a commitment to improve perinatal mental health services (Question 17971/17 asked on 11 Apr 2017 - Maternity Services Provision)

Minister for Health (Deputy Simon Harris): Ireland’s first National Maternity Strategy - Creating A Better Future Together 2016 - 2026 - aims to ensure that appropriate care pathways are in place in order that mothers, babies and families get the right care, at the right time, by the right team and in the right place. Similarly, it recognises that, while all pregnant women need a certain level of support, some will require more specialised care. Accordingly it proposes an integrated model of c...

572. Deputy Clare Daly asked the Minister for Health the average cost of an emergency caesarean and of an elective caesarean as paid for under the maternity and infant care scheme. (Question 17974/17 asked on 11 Apr 2017 - Maternity Services)

Minister for Health (Deputy Simon Harris): In relation to your query regarding the average cost of an emergency caesarean section and of an elective caesarean section, I have asked the HSE to respond to you directly.
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122. Deputy Clare Daly asked the Minister for Health the number of hospitals that perform routine anomaly scans at 20 weeks; and the timeframe for making such scans available to all pregnant women as a matter of routine. (Question 11823/17 asked on 08 Mar 2017 - Maternity Services)

Minister for Health (Deputy Simon Harris): I am advised that foetal anomaly scans are available in all Hospital Groups. Those hospitals/maternity units currently providing anomaly scans accept referrals from other maternity units, if requested. This occurs where the medical team in the referring maternity unit consider that an anomaly scan is clinically indicated. 
The National Maternity Strategy is very clear that all women must have equal access to standardised ultrasound services and, conseq...

400. Deputy Clare Daly asked the Minister for Health his plans to make non-invasive prenatal testing available through the public health system; and if he will make a statement on the matter. (Question 6843/17 asked on 14 Feb 2017 - Maternity Services Provision)

Minister for Health (Deputy Simon Harris): In relation to this particular issue, as this is a service matter, I have asked the HSE to respond to you directly.
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14. Deputy Clare Daly asked the Minister for Health his views on the implications for patient safety of the shortfall in midwifery posts in maternity hospitals, particularly in Dublin; and his further views on whether this shortfall may lead to an increase on the sums paid out annually by the State Claims Agency in maternity cases, which amounted to €379 million in damages and legal costs in the years 2007 to 2015. (Question 37783/16 asked on 01 Dec 2016 - Maternity Services)

Deputy Clare Daly: The former master of the Coombe Hospital has said unequivocally that Ireland has long been skating on dangerously thin ice when it comes to maternity services. His view seems to be supported by the phenomenal sums the State Claims Agency has paid out in maternity cases. A total of €379 million was paid in damages and legal costs between 2007 and 2015. Is the Minister concerned about the impact of the crisis in midwifery on patient safety?
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540. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 97 of 18 October 2016, if the figures provided in tabular form in reply to the question include the 78 midwives recruited since moneys were allocated to recruit 100 additional midwives or if the figures pertain to the period before that recruitment took place. (Question 37158/16 asked on 29 Nov 2016 - Maternity Services)

Minister for Health (Deputy Simon Harris): In relation to this particular query, as this is a service matter, I have asked the HSE to respond to you directly.
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92. Deputy Clare Daly asked the Minister for Health if he will provide specific evidence of the implementation of the national maternity strategy; his views regarding the funds that have been made available for its implementation; and if he will make a statement on the matter. (Question 30355/16 asked on 18 Oct 2016 - Maternity Services)

Minister for Health (Deputy Simon Harris): The National Women & Infants Health Programme will lead the implementation of Ireland’s first National Maternity Strategy - Creating A Better Future Together 2016-2026. The Programme will lead the management, organisation and delivery of maternity, gynaecology and neonatal services, across primary, community and secondary care, strengthening such services by bringing together work that is currently undertaken across a number of divisions. Work to esta...

97. Deputy Clare Daly asked the Minister for Health his views regarding the 17% deficit in the number of midwifery staff needed to run maternity services cited by the master of the Coombe hospital on 13 September 2016 at a patient safety conference run by the State Claims Agency; the steps he will take to address this deficit; and if he will make a statement on the matter. (Question 30354/16 asked on 18 Oct 2016 - Maternity Services)

Minister for Health (Deputy Simon Harris): In May, the HSE granted approval to the Hospital Groups to recruit an additional 100 midwives. The allocation of these midwives was informed by the findings of the Birth Rate Plus midwifery workforce project. 
In relation to the specific query raised, as this is a service matter, I have asked the HSE to respond to you directly.
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414. Deputy Clare Daly asked the Minister for Health if he will provide figures that show that every 13 hour shift in the delivery suites in the three Dublin maternity hospitals are staffed to their full complement; and if he will make a statement on the matter. (Question 30360/16 asked on 18 Oct 2016 - Maternity Services)

Minister for Health (Deputy Simon Harris): In May, the HSE granted approval to the Hospital Groups to recruit an additional 100 midwives. The allocation of these midwives was informed by the findings of the Birth Rate Plus midwifery workforce project.
In relation to the specific query raised, as this is a service matter, I have asked the HSE to respond to you directly.
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182. Deputy Clare Daly asked the Minister for Health in respect of his comments at the Joint Committee on Health on 29 September 2016, the reason there are no national guidelines for dealing with maternal death; the reason the HSE did not approach the widowers and partners whose names are in HSE records who have endured maternal deaths for appropriate support guidelines, based on those views. (Question 28840/16 asked on 05 Oct 2016 - Maternity Services)

Minister for Health (Deputy Simon Harris): The National Guidelines for Bereavement Care Following Maternal Death within a Hospital Setting are being developed by the National Bereavement Care Sub-Group to improve and standardise bereavement care provided to families in the aftermath of an early or late maternal death. Accordingly, I have asked the Health Service Executive (HSE) to respond to you directly on this matter.
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608. Deputy Clare Daly asked the Minister for Health if he will commission a fully independent hospital wide review of VBAC counselling at Lourdes hospital, rather than the HSE managed review of an individual case with no start or completion date and no review of any of the other cases, despite the fact that its own limited audit of 2011 cases highlighted over 50% of cases had no documentation of the risks of VBAC being discussed. (Question 26670/16 asked on 27 Sep 2016 - Maternity Services)

Minister for Health (Deputy Simon Harris): The individual case referred to has been the subject of correspondence between the family involved, the HSE and the Department of Health. The Deputy National Director, Acute Hospitals Division, HSE is dealing directly with the concerns raised. As a result of this I have referred this matter to the HSE to respond to you directly.
A new model of care has been developed for maternity services within the National Maternity Strategy which was launched in Jan...

609. Deputy Clare Daly asked the Minister for Health his views on the HSE’s apparent widespread failure to counsel on the risks of VBAC to enable persons to make an informed birthing choice; and if he will make a statement on the matter. (Question 26671/16 asked on 27 Sep 2016 - Maternity Services)

Minister for Health (Deputy Simon Harris): The National Maternity Strategy, which was launched last January, espouses a new model of maternity care. The Strategy recommends that services should be woman-centred and provide integrated, team-based care, with women seeing the most appropriate professional, based on need. Central to the Strategy is the need for women to have access to all the necessary information, in a readily understandable format, to allow then to make informed choices regarding ...

662. Deputy Clare Daly asked the Minister for Health his views on the fact that in the week of 6 June 2016 a total of four qualified midwives and a student midwife were covering nine delivery rooms, working 13-hour shifts, in the Rotunda Hospital; the steps he has taken to deal with staffing problems; and if he will make a statement on the matter. (Question 26935/16 asked on 27 Sep 2016 - Maternity Services)

Minister for Health (Deputy Simon Harris): As this is a service matter, I have asked the HSE to respond to you directly.
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663. Deputy Clare Daly asked the Minister for Health his views on how he proposes to deal with problems in our maternity services, with particular reference to the fact that eight maternity units are under investigation; and if he will make a statement on the matter. (Question 26936/16 asked on 27 Sep 2016 - Maternity Services)

Minister for Health (Deputy Simon Harris): The National Maternity Strategy, which was launched last January, espouses a new model of maternity care. The Strategy recommends that services should be woman-centred and provide integrated, team-based care, with women seeing the most appropriate professional, based on need. One of the high level priorities of the Strategy is to ensure that women have access to safe, high quality, nationally consistent, woman centred care. The new model of care will...

261. Deputy Clare Daly asked the Minister for Health the steps he is taking to resolve the governance conflict between St. Vincent’s University Hospital and the National Maternity Hospital; if any agreement on governance will first and foremost protect the needs and interests of women and supersede the institutional interests of both hospitals including the mastership system of the National Maternity Hospital. (Question 12014/16 asked on 25 May 2016 - Maternity Services Provision)

Minister for Health (Deputy Simon Harris): I propose to take Questions Nos. 261 and 262 together.
I am very aware of the difficulties in relation to this project and the efforts that have been undertaken to mediate a resolution. Meetings were held last year with both hospitals at departmental and ministerial level and, at the request of Minister Varadkar, a facilitated dialogue was undertaken earlier this year. 
Since I took office earlier this month, I have met with representatives of both hos...